When selecting the proper type of implant for your needs, your board-certified plastic surgeon will discuss various strategies, including under muscle vs. over muscle implants. Over muscle implants are called subglandular, while under the muscle implants are referred to as submuscular. Which is better, over vs under muscle implant? There is no hard-and-fast rule that applies in all situations.
Instead, it is critical for your surgeon to consider various aspects of this breast augmentation surgery based on your anatomy, personal goals, as well as any limitations present. Also, note that the surgeon’s expertise in each of these areas could determine if subglandular vs. submuscular is right for you. If you’ve researched and vetted your surgeon, trust that they are going to help you have the outcome you desire.
Understanding Subglandular (Over the Muscle) Placement
Subgladular placement involves the surgeon positioning the implant in front of the muscle. It is located behind the glandular tissue and fat of the breast. This often aids in accommodating a larger breast size, and it reduces some of the recovery since no change is made to the chest muscle.
Pros of Over the Muscle
There are benefits to using subglandular placement, including the fact that it is a simpler surgery and, therefore, allows for a faster recovery time. It also creates immediate fullness. If you have sufficient tissue coverage, this option may be a good fit for you.
Cons of Over the Muscle
There are some drawbacks here, including a higher chance that the implant’s edges will be visible if you have thinner skin. Also, there is a higher risk of a more noticeable rippling effect. You may also have concerns if you have sagging skin, as it will create less of a fitted look.
Understanding Submuscular (Under the Muscle) Placement
Submuscular placement involves the placement of the breast implant partially under the pectoralis major muscle. This positions it so that the top and much of the inner portion are covered by muscle. Overall, this creates a more natural look, and the implant is less visible.
Pros of Under the Muscle
There are some benefits to this process, including that it is a more natural look for people who are thinner. Moreover, the way the muscle coverage sits makes it harder to see any components of the visible edges of the implant.
Cons of Under the Muscle
There are some drawbacks to consider for some patients, such as less movement of the chest overall. We also want to be careful about selecting volume and projection since these are more pronounced.
Factors Influencing Your Best Placement Choice
With subglandular vs. submuscular considerations, it is critical to look at the whole patient’s needs. Our surgeon will consider a variety of factors when making these decisions. Dr. Khanna emphasizes the importance of respecting a person’s anatomy in these decisions, including the breast width, chest wall shape, posture, and other factors. Additionally, factors you may not have thought about, such as breast tissue thickness, muscle structure, and a person’s posture, all play a role in this decision.
“We want to respect your autonomy,” shares Dr. Khanna. “And if we go too big, that looks abnormal. But, too small, that looks abnormal, too.”
3D Imaging (Vectra) and Measurements
As we take into consideration the actual decisions to be made here, we use technology to offer help. Vectra 3D imaging is a primary tool that can offer a preview of the potential sizes and shapes of the implant, making breast augmentation more visually understood. This can also help reveal the chest wall contour and muscle definition a patient has. These are all critical factors in determining the best placement of the implant.
Dr. Khanna shares, “We use Vectra to learn about your anatomy…and your breast shape.” That gives them insight into the options available, and ultimately, this will provide information on what will work and what will not work.
By seeing a 3D model of your chest, you and your surgeon can discuss how an implant might look if placed in front of or behind the pectoralis muscle—and whether the muscle thickness will offer adequate coverage.
Defining Your Desired Look
The ultimate goal with under muscle breast implant surgery vs over has to come down to what you desire to see in the finished product. We encourage you to bring a photo example or two of what you like or do not like. Communicate with us about your specific aesthetic goal.
In-Clinic Sizing and Final Decision
About six weeks prior to your breast augmentation surgery, we provide a formal sizing session. This is done using trial-sized implants, which gives you a better idea of what the options are. You cannot truly replicate the over or under the muscle differences here with a try-on application. However, we can use this process to get a better idea of what your desired look is, including volume and projection.
This allows us to determine the sizing that fits your goals and which placement may be best for you to achieve those objectives. This includes areas of upper-pole fullness vs subtle, more natural contours.
What to Expect from Surgery and Recovery
During your appointments, our team will provide you with insight into what breast implant placement we believe may be best for you based on your objectives. You will find that both procedures have some downtime with breast tissue healing with implants under the muscle, tending to take longer to heal with more restrictions. With fewer breast tissue changes and no chest muscle contracts, over the muscle methods tend to be beneficial to many.
With our guidance, we can provide you with insight into not just selection but how to manage the entire recovery and healing process. We tailor every recovery process based on your individual needs.
The Holistic Approach at ICLS
We are committed to providing you with a thorough consultation, and we respect your body’s natural shape and size. By doing this, we can integrate your preferences, measurements, and 3D imaging into creating the best possible look for your needs.
If you are considering the options and are unsure if over the muscle vs. under the muscle implant pictures are enough to decide, speak to our team. We will offer answers to any questions you have. Contact us if you have any questions or to set up a consultation.
FAQs
Is it better to get breast implants over or under the muscle?
There is no “better” as the decision depends on your natural breast tissue, desired goals in look, and your overall anatomy.
Do over-the-muscle implants look more natural?
For many people, under the muscle implants create a more natural look because there is a smoother transition between the chest wall and the implant.
What are the cons of under-the-muscle implants?
Placing the implant under the muscle tissue may require more care and recovery time.
Do over-the-muscle implants sag more?
In some situations, this can be a problem. Our doctors will work with you to determine if this could be a concern in your case.
What are the cons of over-the-muscle breast implants?
The biggest potential drawback applies to those with thin skin, which can mean that the edges of the implant are more visible.
Do breast implants under the muscle feel more natural?
They could have a more natural feeling, depending on the size you select. The muscle creates a more natural look, which also contributes to the overall feel.
How can I tell if my implants are over or under the muscle?
Set up a consultation with our team. Let us take a look.
Is it better to have breast implants above or below the muscle for reconstruction?
Typically, below the muscle is a better option. It offers a more natural appearance, and there’s less visibility of the implant’s rippling.
How many cc’s do you lose going under the muscle?
This is dependent on the size of the breast implant and the look you desire. In some situations, this could lead to a 30 to 50 cubic centimetre reduction.